Vidigal E, Jacoby R K, Dixon A S, Ratliff A H, Kirkup J
Ann Rheum Dis. 1975 Aug;34(4):292-7. doi: 10.1136/ard.34.4.292.
The feet of 200 consecutive admissions with classical or definite rheumatoid arthritis were studied. 104 were found to have pain or deformity. Clinical involvement of the joints was seen more often than radiological joint damage in the ankle, but the reverse was the case in the midtarsal joints. The metatarsophalangeal joints were involved most frequently both clinically and radiologically. Sixty per cent of the patients required modified shoes but only a third of these had received them. The need for more shoes is clear, and although this is a highly selected group of patients they were all under specialist care. The increased expenditure on special footwear would benefit the patient, firstly by improving ambulation, and secondly perhaps by reducing the number of operations necessary. Hallux valgus was very common and occurred with similar frequency to disease in the other metatarsophalangeal joints. Although not exclusive to rheumatoid arthritis, hallux valgus must have been caused for the most part by the rheumatoid arthritis and if so, then it is suggested that the provision of suitable shoes for patients may be less costly than subsequent surgical treatment.
对200例连续性确诊为典型或明确类风湿性关节炎的患者的足部进行了研究。发现其中104例存在疼痛或畸形。踝关节的临床关节受累比放射学关节损伤更为常见，但跗中关节的情况则相反。跖趾关节在临床和放射学上受累最为频繁。60%的患者需要改良鞋，但其中只有三分之一的患者已经收到了改良鞋。显然需要更多的鞋子，尽管这是一组经过高度挑选的患者，但他们都接受了专科护理。增加特殊鞋类的支出将使患者受益，首先是通过改善行走能力，其次可能是通过减少所需手术的数量。拇外翻非常常见，其发生频率与其他跖趾关节疾病相似。虽然拇外翻并非类风湿性关节炎所特有，但很可能在很大程度上是由类风湿性关节炎引起的，如果是这样，那么为患者提供合适的鞋子可能比后续的手术治疗成本更低。
